Self-care for lichen sclerosus

Written by Lotte Boekhout

When you are diagnosed with lichen sclerosus, you often find yourself quite quickly in a medical world of ointments and check-ups. And although that guidance is incredibly important, I soon noticed that there is another layer too. A layer of gentleness, attunement and learning to feel what your body needs. For me, living with lichen sclerosus is not only about reducing symptoms, but also about how you care for yourself in everyday life.

Having experienced the condition myself, I now know that self-care for lichen sclerosus goes far beyond ‘simply applying your ointment properly’. It is precisely in the small choices you make each day that you can give your skin more calm and support your body more fully. In this blog, I share the advice I received, supplemented by my own experience, tips and the things that have made a real difference for me.

Preventing skin irritation with lichen sclerosus

Advice from GPs and gynaecologists often focuses first and foremost on preventing skin irritation. And rightly so: the less irritation there is, the more opportunity your skin has to settle. Here are the main recommendations at a glance:

• Wash your vulva with lukewarm water only, without a flannel or soap.
• Wear cotton underwear rather than synthetic fabrics that chafe.
• Sleep without underwear so that your skin can recover during the night.
• Avoid tight clothing such as sports leggings or jeans.
• Buy a good bicycle saddle that puts less pressure on your vulva (I personally like a Texel sheepskin saddle cover).
• Wash your vulva with lukewarm water only, without a flannel or soap.

I would like to add something about that last point: do not use special ‘feminine wash’ either. In my view, these products really are nonsense. Your vulva and vagina have a natural acidity that regulates itself. Such products often disrupt that balance and may actually make irritation from lichen sclerosus worse.

When you are on your period, look carefully at what feels most comfortable for you. Inserting a cup or tampon may be painful, while sanitary pads may feel hot and clammy. My tip is to experiment with washable period underwear or choose organic tampons or sanitary pads without chemical additives.

Treatment with steroid ointment

The standard treatment for lichen sclerosus is a corticosteroid cream, a powerful anti-inflammatory medication. Dermovate (clobetasol) is often prescribed and can quickly reduce itching and pain.

There are different views about how long you can use this steroid ointment for lichen sclerosus. Some people worry that it will make the skin thinner, but research shows that long-term use at a lower dose can be safe and effective—even when you have few or no symptoms. Continuing to apply it often means that lichen sclerosus flares up less quickly. It also reduces the risk of fusion, scarring and vulval cancer. Always discuss with your doctor what is appropriate for your particular situation.

Emollient ointment for lichen sclerosus

Alongside the steroid ointment, it is important to keep your skin well moisturised, preferably at least twice a day. Doctors often prescribe a greasy petroleum-jelly-based ointment, but I personally find that these petroleum-derived products seem to seal my skin rather than truly nourish it.

In my own experience, natural oils often feel much more comfortable with lichen sclerosus. Examples include shea butter (anti-inflammatory and my personal favourite), coconut oil and jojoba oil.

You can also choose specialist products such as Puur Vrouw Regeneratieolie or Peach ’n Love oil by Healing Mary. These products are not cheap, but when you live with such vulnerable symptoms, I think it is important to allow yourself something that genuinely feels pleasant.

There is something else I consider important here: do not apply the ointment or oil quickly simply because you ‘have to’. If you can, turn it into a loving ritual, especially in bed in the evening. Take your time, give that area your attention and touch yourself gently. That alone can begin to change how you relate to your body.

Never have sex through pain

The natural oils I mention above can also feel very pleasant as lubricants for lichen sclerosus. Ordinary lubricants often contain ingredients that can dry out the skin or cause a burning sensation.

With lichen sclerosus, it is particularly important to take your time with intimacy. A nourishing oil can make touch, relaxation and foreplay feel much gentler. My most important advice is simple: never have sex through pain. Your body deserves safety, gentleness and relaxation. Choose something that lubricates well and nourishes the skin, rather than a water-based lubricant that dries out quickly.

Other tips for lichen sclerosus

There are a few other things that some women may find helpful as part of their self-care:

Warm sitz baths

A sitz bath with sea salt or chamomile may have a soothing effect on lichen sclerosus symptoms.

Applying warmth

Warmth often helps to reduce tension and discomfort. For example, you can sit on a warm cherry-stone cushion or hot-water bottle, with your clothes on as usual.

Be careful with yoni steaming

Although this is sometimes recommended for vaginal symptoms in alternative medicine, I strongly advise against it for lichen sclerosus. The vulnerable skin can be burnt or become more irritated, and the risk of infection also increases.

Clay mask for lichen sclerosus

Some women find a clay mask beneficial. You make one by mixing white clay powder with jojoba oil and water to form a paste. Apply it to your vulva, but only if you have no sores or fissures. Then place a warm, wet towel over it to prevent the clay from drying out. After about ten minutes, rinse it off thoroughly and apply a natural oil to your skin again. The first time, you may wish to try it for a shorter period to see how your skin responds. I buy my natural oils and clay from Natural Heroes.

Look at yourself with love

The usual advice is to examine yourself with a mirror each month so that you notice changes in colour, shape or skin texture sooner. That is valuable, and I understand why it is recommended.

At the same time, I would like to invite you to add something else. Try not to look at yourself only from a place of monitoring or fear, but also with gentleness. With love. Do not look only at what has changed or what you may find difficult to see; try to be present with your own body with compassion.

That did not feel natural to me at all in the beginning. Yet by looking calmly more often, something also changed in my relationship with my body. Not all at once, but step by step. Perhaps it can be that way for you too.

Conclusion

For me, self-care for lichen sclerosus goes beyond medical treatment alone. By caring gently for your skin, preventing irritation and truly listening to what your body needs, your symptoms can begin to settle.

Read my latest articles about lichen sclerosus

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• Nutrition and lichen sclerosus
• The pelvic floor and lichen sclerosus